An increasing scabies incidence in Croatia: A call for coordinated action among dermatologists, physicians and epidemiologists
Article Category: Research Article
Published Online: Oct 18, 2020
Page range: 264 - 272
Received: May 12, 2020
Accepted: Sep 18, 2020
DOI: https://doi.org/10.2478/sjph-2020-0033
Keywords
© 2020 National Institute of Public Health, Slovenia
This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.
Introduction
The aim of our study was to examine the scabies incidence in the Croatian population and to analyse potential related factors.
Methods
This mixed ecological study is based on a retrospective medical record review. National data from communicable disease reports was sourced and analysed for an 11-year period (2007-2017), with more focus on the period 2014-2017. Descriptive statistics were used to calculate trends. Differences between the groups were studied using Chi-square test and Kendall’s tau (τ) correlation coefficient. Levels of significance were set at p<0.05 or p<0.01.
Results
From 2007 to 2017, scabies infestation in Croatia increased by 6-fold, particularly affecting children and young adults (19 years or younger). In the period 2014-2017, border counties which are part of migration flows were the counties with the highest average scabies incidences. A linear trend of increase in the number of tourists, immigrants and scabies infestations was noted on the national level for the analysed period, although a significant association was not observed. Regarding outbreaks of scabies within institutions, more than 80% of outbreaks occurred in institutions for adults. In the capital, Zagreb, the crude incidence rate increased 3-fold between 2014 and 2017.
Conclusions
The increased incidence of scabies, large disparities between counties, and prolonged outbreaks within families due to under-recognition and misdiagnoses points to a need for increased awareness among health practitioners. To the best of our knowledge, this is the first recent epidemiologic analysis on this topic, not only in Croatia but within the wider geographic region as well.